Organization
CHOCTAW NATION OF OKLAHOMA
Active
Other names
Choctaw Nation Health Clinic - Broken Bow
Organization subpart
No
Provider details
NPI number
Authorized official
TODD A HALLMARK (EXECUTIVE OFFICER - HEALTH)
(918) 567-7115
Entity
Organization
Contact information
Practice address
1300 E MARTIN LUTHER KING DR, BROKEN BOW, OK 74728-4160
(918) 567-7000
(918) 567-7180
Mailing address
1 CHOCTAW WAY, TALIHINA, OK 74571-2022
(918) 567-7000
(918) 567-7180
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
259962
LICENSE
OK
Enumeration date
05/29/2025
Last updated
01/08/2026
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